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Bone Health: Nutritional Perspectives

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 March 2016) | Viewed by 56353

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Special Issue Editors

Prof. Dr. Marlena Kruger

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Guest Editor

School of Health Sciences, Massey University, Palmerston North 4442, New Zealand
Interests: bone health; osteoarthritis; osteoporosis; aging; long chain fatty acids; micronutrients; in vitro models for bone health
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Hope Weiler

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Guest Editor

School of Dietetics and Human Nutrition, McGill University, Ste Anne de Bellevue, QC H9X 3V9, Canada
Interests: bone health; vitamin D and essential fatty acid intake

Special Issue Information

Dear Colleagues,

In the prevention of osteoporosis, recognized as a major public health problem, nutrition may appear as an alternative strategy for optimizing skeletal health. The importance of adequate calcium and vitamin D intakes for bone health is now well documented. Dairy products may be seen as just providing calcium, other minerals, and protein, but may contain some bioactive fractions that are bone active, with benefits beyond calcium and minerals. Other essential nutrients, such as the omega 3 long chain fatty acids, also affect bone health. The human diet contains a complex array of non-nutrient natural bioactive molecules, namely phytochemicals, which may act and protect bone; these include the polyphenols. These compounds may be partly responsible for some of the positive links found between fruit and vegetables intake and bone mineral density in adults and children. High fruit and vegetables intake could also enhance the intake of potassium and affect systemic and localized acid–base balance, thereby affecting bone health.

We invite investigators to contribute original research articles, as well as review articles that will provide new insights into the physiological response to nutritional interventions or dietary patterns at any life stage. In addition, research that aims to clarify the molecular mechanisms of action by specific nutrients on the musculoskeletal system and respective cells are desirable. We will assume that intervention studies presented will have been designed to provide sufficient dietary calcium. Studies documenting interaction among nutrients are also welcome. Research presented may cover nutrition in childhood and adolescence, in adults, as well as in the elderly, with the intention to prevent or treat osteoporosis. Clinical trials must have been registered with a known database.

Prof. Dr. Marlena Kruger
Prof. Dr. Hope Weiler
Guest Editors

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Keywords

milk and dairy products
phytoestrogens
Omega 3 fats
fruit and vegetables
potassium
favonoids and other polyphenols
bioactives from colostrum or milk
other lipids
trace minerals
osteoporosis
bone cells
osteoclasts
osteoblasts
ageing
bone growth
etc.

Published Papers (10 papers)

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Research

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284 KiB

Open AccessArticle

Dietary Fluoride Intake and Associated Skeletal and Dental Fluorosis in School Age Children in Rural Ethiopian Rift Valley

by Aweke Kebede, Negussie Retta, Cherinet Abuye, Susan J. Whiting, Melkitu Kassaw, Tesfaye Zeru, Masresha Tessema and Marian Kjellevold

Int. J. Environ. Res. Public Health 2016, 13(8), 756; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13080756 - 26 Jul 2016

Cited by 44 | Viewed by 5576

Abstract

An observational study was conducted to determine dietary fluoride intake, diet, and prevalence of dental and skeletal fluorosis of school age children in three fluorosis endemic districts of the Ethiopian Rift Valley having similar concentrations of fluoride (F) in drinking water (~5 mg F/L). The duplicate plate method was used to collect foods consumed by children over 24 h from 20 households in each community (n = 60) and the foods, along with water and beverages, were analyzed for fluoride (F) content. Prevalence of dental and skeletal fluorosis was determined using presence of clinical symptoms in children (n = 220). Daily dietary fluoride intake was at or above tolerable upper intake level (UL) of 10 mg F/day and the dietary sources (water, prepared food and beverages) all contributed to the daily fluoride burden. Urinary fluoride in children from Fentale and Adamitulu was almost twice (>5 mg/L) the concentration found in urine from children from Alaba, where rain water harvesting was most common. Severe and moderate dental fluorosis was found in Alaba and Adamitulu, the highest severity and prevalence being in the latter district where staple foods were lowest in calcium. Children in all three areas showed evidence of both skeletal and non-skeletal fluorosis. Our data support the hypothesis that intake of calcium rich foods in addition to using rain water for household consumption and preparation of food, may help in reducing risk of fluorosis in Ethiopia, but prospective studies are needed. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

587 KiB

Open AccessArticle

Urinary Mineral Concentrations in European Pre-Adolescent Children and Their Association with Calcaneal Bone Quantitative Ultrasound Measurements

by Karen Van den Bussche, Diana Herrmann, Stefaan De Henauw, Yiannis A. Kourides, Fabio Lauria, Staffan Marild, Dénes Molnár, Luis A. Moreno, Toomas Veidebaum, Wolfgang Ahrens and Isabelle Sioen

Int. J. Environ. Res. Public Health 2016, 13(5), 471; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13050471 - 05 May 2016

Cited by 3 | Viewed by 4324

Abstract

This study investigates differences and associations between urinary mineral concentrations and calcaneal bone measures assessed by quantitative ultrasonography (QUS) in 4322 children (3.1–11.9 years, 50.6% boys) from seven European countries. Urinary mineral concentrations and calcaneal QUS parameters differed significantly across countries. Clustering revealed a lower stiffness index (SI) in children with low and medium urinary mineral concentrations, and a higher SI in children with high urinary mineral concentrations. Urinary sodium (uNa) was positively correlated with urinary calcium (uCa), and was positively associated with broadband ultrasound attenuation and SI after adjustment for age, sex and fat-free mass. Urinary potassium (uK) was negatively correlated with uCa but positively associated with speed of sound after adjustment. No association was found between uCa and QUS parameters after adjustment, but when additionally adjusting for uNa, uCa was negatively associated with SI. Our findings suggest that urinary mineral concentrations are associated with calcaneal QUS parameters and may therefore implicate bone properties. These findings should be confirmed in longitudinal studies that include the food intake and repeated measurement of urinary mineral concentrations to better estimate usual intake and minimize bias. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

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1335 KiB

Open AccessArticle

Supraphysiological Levels of Quercetin Glycosides are Required to Alter Mineralization in Saos2 Cells

by Leslie A. Nash, Sandra J. Peters, Philip J. Sullivan and Wendy E. Ward

Int. J. Environ. Res. Public Health 2016, 13(5), 460; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13050460 - 29 Apr 2016

Cited by 5 | Viewed by 4211

Abstract

Flavonoid intake is positively correlated to bone mineral density (BMD) in women. Flavonoids such as quercetin exhibit strong anti-oxidant and anti-inflammatory activity that may be beneficial for bone health. Quercetin, previously shown to positively influence osteoblasts, is metabolized into glycosides including rutin and hyperoside. We compared the effects of these glycosides on mineralization in human osteoblast (Saos2) cells. Administration of rutin (≥25 µM) and hyperoside (≥5 µM) resulted in higher mineral content, determined using the alizarin red assay. This was accompanied by higher alkaline phosphatase activity with no cell toxicity. The expression of osteopontin, sclerostin, TNFα and IL6, known stimuli for decreasing osteoblast activity, were reduced with the addition of rutin or hyperoside. In summary, rutin and hyperoside require supraphysiological levels, when administered individually, to positively influence osteoblast activity. This information may be useful in developing nutraceuticals to support bone health. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

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1142 KiB

Open AccessArticle

Impact of Geographic Location on Vitamin D Status and Bone Mineral Density

by Kyung-Jin Yeum, Byeng Chun Song and Nam-Seok Joo

Int. J. Environ. Res. Public Health 2016, 13(2), 184; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13020184 - 02 Feb 2016

Cited by 38 | Viewed by 5116

Abstract

A significant decline of serum 25-hydroxyvitamin D concentration [25(OH)D] with increasing latitude has been reported only for Caucasians. To determine the association between serum 25(OH)D and geographic location and its impact on bone mineral density (BMD) in an Asian population, a total of 17,508 subjects (8910 men and 8598 women) from the 2008–2010 Korea National Health and Nutrition Examination Survey (KNHANES) were stratified into four age groups and analyzed for 25(OH)D and BMD according to geographic location (South, 33° N–35° N; Middle, 36° N; North, 37° N–38° N). Mean 25(OH)D were 47.7 and 41.2 nmol/L; calcium intake, 564.9 & 442.3 mg/d; femoral neck BMD, 0.829 & 0.721 g/cm²; and lumbar spine BMD, 0.960 & 0.918 g/cm² for men and women, respectively. Both men and women living in the South had significantly higher 25(OH)D and femoral neck BMD for those ≥50 years old. Lumbar spine BMD was significantly higher in men ≥50 years old, and for women 10–29 & 50–69 years old living in the South. A 1 or 2 degree difference in latitude has a significant effect on serum 25(OH)D and BMD in this low vitamin D status population. Thus, consideration of geographic location for a recommendation of vitamin D intake may be necessary. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

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567 KiB

Open AccessArticle

Associations of Age, BMI, and Years of Menstruation with Proximal Femur Strength in Chinese Postmenopausal Women: A Cross-Sectional Study

by Huili Kang, Yu-Ming Chen, Guiyuan Han, Hua Huang, Wei-Qing Chen, Xidan Wang, Ying-Ying Zhu and Su-Mei Xiao

Int. J. Environ. Res. Public Health 2016, 13(2), 157; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13020157 - 23 Jan 2016

Cited by 10 | Viewed by 4383

Abstract

This study aimed to elucidate the associations of age, BMI, and years of menstruation with proximal femur strength in Chinese postmenopausal women, which may improve the prediction of hip fracture risk. A cross-sectional study was conducted in 1322 Chinese postmenopausal women recruited from communities. DXA images were used to generate bone mineral density (BMD) and geometric parameters, including cross-sectional area (CSA), outer diameter (OD), cortical thickness (CT), section modulus (SM), buckling ratio (BR) at the narrow neck (NN), intertrochanter (IT), and femoral shaft (FS). Relationships of age, BMI, and years of menstruation with bone phenotypes were analyzed with the adjustment of height, age at menarche, total daily physical activity, education, smoking status, calcium tablet intake, etc. Age was associated with lower BMD, CSA, CT, SM, and higher BR (p < 0.05), which indicated a weaker bone strength at the proximal femur. BMI and years of menstruation had the positive relationships with proximal femur strength (p < 0.05). Further analyses showed that the ranges of absolute value of change slope per year, per BMI or per year of menstruation were 0.14%–1.34%, 0.20%–2.70%, and 0.16%–0.98%, respectively. These results supported that bone strength deteriorated with aging and enhanced with higher BMI and longer time of years of menstruation in Chinese postmenopausal women. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

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707 KiB

Open AccessArticle

Commercial Honeybush (Cyclopia spp.) Tea Extract Inhibits Osteoclast Formation and Bone Resorption in RAW264.7 Murine Macrophages—An in vitro Study

by Amcois Visagie, Abe Kasonga, Vishwa Deepak, Shaakirah Moosa, Sumari Marais, Marlena C. Kruger and Magdalena Coetzee

Int. J. Environ. Res. Public Health 2015, 12(11), 13779-13793; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph121113779 - 28 Oct 2015

Cited by 19 | Viewed by 6530

Abstract

Honeybush tea, a sweet tasting caffeine-free tea that is indigenous to South Africa, is rich in bioactive compounds that may have beneficial health effects. Bone remodeling is a physiological process that involves the synthesis of bone matrix by osteoblasts and resorption of bone by osteoclasts. When resorption exceeds formation, bone remodeling can be disrupted resulting in bone diseases such as osteoporosis. Osteoclasts are multinucleated cells derived from hematopoietic precursors of monocytic lineage. These precursors fuse and differentiate into mature osteoclasts in the presence of receptor activator of NF-kB ligand (RANKL), produced by osteoblasts. In this study, the in vitro effects of an aqueous extract of fermented honeybush tea were examined on osteoclast formation and bone resorption in RAW264.7 murine macrophages. We found that commercial honeybush tea extract inhibited osteoclast formation and TRAP activity which was accompanied by reduced bone resorption and disruption of characteristic cytoskeletal elements of mature osteoclasts without cytotoxicity. Furthermore, honeybush tea extract decreased expression of key osteoclast specific genes, matrix metalloproteinase-9 (MMP-9), tartrate resistant acid phosphatase (TRAP) and cathepsin K. This study demonstrates for the first time that honeybush tea may have potential anti-osteoclastogenic effects and therefore should be further explored for its beneficial effects on bone. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

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849 KiB

Open AccessArticle

Combined Effects of Soy Isoflavones and β-Carotene on Osteoblast Differentiation

by Yoriko Nishide, Yuko Tousen, Miki Tadaishi, Masaki Inada, Chisato Miyaura, Marlena C. Kruger and Yoshiko Ishimi

Int. J. Environ. Res. Public Health 2015, 12(11), 13750-13761; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph121113750 - 28 Oct 2015

Cited by 29 | Viewed by 5855

Abstract

Soy isoflavones, genistein, daidzein and its metabolite equol, as well as β-carotene have been reported to be effective for maintaining bone health. However, it remains to be elucidated whether combining soy isoflavones with β-carotene is beneficial to bone formation. This study investigated the combined effect of soy isoflavones and β-carotene on the differentiation of MC3T3-E1 preosteoblastic cells. Daidzein and genistein alone did not affect cell growth but increased alkaline phosphatase (ALP) activity. Beta-carotene alone inhibited cell growth and markedly enhanced ALP activity. Soy isoflavones combined with β-carotene resulted in higher ALP activity than treatment with isoflavones or β-carotene alone. We observed significant main effects of β-carotene on the enhanced expression of Runx2, ALP, and ostepontin mRNA, whereas there was a significant main effect of soy isoflavones on the expression of osterix mRNA. To investigate how β-carotene affected osteoblast differentiation, MC3T3-E1 cells were treated with retinoic acid receptor (RAR) pan-antagonist combined with β-carotene. Osteopontin and ALP mRNA expression levels, which were increased following treatment with β-carotene, were significantly suppressed by the RAR pan-antagonist. This suggests treatment with β-carotene enhanced early osteoblastic differentiation, at least in part via RAR signaling. These results indicate that a combination of isoflavones and β-carotene may be useful for maintaining a positive balance of bone turnover by inducing osteoblast differentiation. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

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Review

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777 KiB

Open AccessReview

BMI and BMD: The Potential Interplay between Obesity and Bone Fragility

by Andrea Palermo, Dario Tuccinardi, Giuseppe Defeudis, Mikiko Watanabe, Luca D’Onofrio, Angelo Lauria Pantano, Nicola Napoli, Paolo Pozzilli and Silvia Manfrini

Int. J. Environ. Res. Public Health 2016, 13(6), 544; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13060544 - 28 May 2016

Cited by 132 | Viewed by 10415

Abstract

Recent evidence demonstrating an increased fracture risk among obese individuals suggests that adipose tissue may negatively impact bone health, challenging the traditional paradigm of fat mass playing a protective role towards bone health. White adipose tissue, far from being a mere energy depot, is a dynamic tissue actively implicated in metabolic reactions, and in fact secretes several hormones called adipokines and inflammatory factors that may in turn promote bone resorption. More specifically, Visceral Adipose Tissue (VAT) may potentially prove detrimental. It is widely acknowledged that obesity is positively associated to many chronic disorders such as metabolic syndrome, dyslipidemia and type 2 diabetes, conditions that could themselves affect bone health. Although aging is largely known to decrease bone strength, little is yet known on the mechanisms via which obesity and its comorbidities may contribute to such damage. Given the exponentially growing obesity rate in recent years and the increased life expectancy of western countries it appears of utmost importance to timely focus on this topic. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

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1294 KiB

Open AccessReview

Lessons from the Bone Chapter of the Malaysian Aging Men Study

by Kok-Yong Chin, Wan Zurinah Wan Ngah and Soelaiman Ima-Nirwana

Int. J. Environ. Res. Public Health 2016, 13(6), 531; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13060531 - 25 May 2016

Cited by 2 | Viewed by 4757

Abstract

Male osteoporosis in Malaysia is a largely neglected problem. Therefore, a bone health study in men using quantitative ultrasonometry was launched as part of the Malaysian Aging Men Study in 2009–2012. This review aimed to summarize the findings of the aforementioned bone health study. The study examined the bone health of Chinese and Malaysian men aged 20 years and above living in Kuala Lumpur using a quantitative ultrasound device. Participants answered a questionnaire on their demographic details and physical activity status. Body anthropometry of the participants was measured and their blood collected for biochemical analysis. Results showed that a significant proportion of the Malaysian Chinese and Malay men had suboptimal bone health indicated by calcaneal speed of sound and vitamin D status. Age-related decline of the calcaneal speed of sound in these men was gradual and biphasic without ethnic difference. Body anthropometry such as height, weight, body mass index, and body fat percentage contributed to the variation of the calcaneal speed of sound in Malaysian men. Age-related changes in testosterone, insulin-like growth factor 1, and thyroid stimulating hormone also influenced the calcaneal speed of sound in these men. This study serves as a reminder that male osteoporosis in Malaysia should be an issue of concern. It is also a basis for a more comprehensive study on bone health in men in the future. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

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887 KiB

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A Mouse Model for Studying Nutritional Programming: Effects of Early Life Exposure to Soy Isoflavones on Bone and Reproductive Health

by Wendy E. Ward, Jovana Kaludjerovic and Elsa C. Dinsdale

Int. J. Environ. Res. Public Health 2016, 13(5), 488; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph13050488 - 11 May 2016

Cited by 7 | Viewed by 4415

Abstract

Over the past decade, our research group has characterized and used a mouse model to demonstrate that “nutritional programming” of bone development occurs when mice receive soy isoflavones (ISO) during the first days of life. Nutritional programming of bone development can be defined as the ability for diet during early life to set a trajectory for better or compromised bone health at adulthood. We have shown that CD-1 mice exposed to soy ISO during early neonatal life have higher bone mineral density (BMD) and greater trabecular inter-connectivity in long bones and lumbar spine at young adulthood. These skeletal sites also withstand greater forces before fracture. Because the chemical structure of ISO resembles that of 17-β-estradiol and can bind to estrogen receptors in reproductive tissues, it was prudent to expand analyses to include measures of reproductive health. This review highlights aspects of our studies in CD-1 mice to understand the early life programming effects of soy ISO on bone and reproductive health. Preclinical mouse models can provide useful data to help develop and guide the design of studies in human cohorts, which may, depending on findings and considerations of safety, lead to dietary interventions that optimize bone health. Full article

(This article belongs to the Special Issue Bone Health: Nutritional Perspectives)

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